Case report of Triumeq (abacavir/dolutegravir/ lamivudine) associated rhabdomyolysis in a human immunodeficiency virus (HIV) infected patient

Abstract

Rationale: With the existence of the human immunodeficiency virus (HIV) infection as a chronic disease, more often adverse effects of its treatment with the various antiretroviral therapies (ARTs) available have been recognized. Going further, Triumeq has been associated with a myriad of adverse effects, of which rhabdomyolysis is rarely reported in the literature. Patient concerns: The patient presented with muscle tenderness over the lower limbs and dark brown-to-red colored urine. Diagnosis: Given the presenting symptoms, as well as the laboratory testing, including elevated serum creatine kinase and liver enzymes, the diagnosis of rhabdomyolysis was made. Interventions: Improvement was achieved rapidly after starting intravenous fluid therapy and with discontinuation of Triumeq. Outcomes After discharge, repeated creatine kinase levels in the clinic have been normal and decision was made to initiate another ART and until now, no further episodes of rhabdomyolysis have developed. Regular outpatient follow-up has been ongoing for over 1 year and no complications have been identified. Lessons: This case aims to recognize rhabdomyolysis as a rare, but possible adverse effect associated with the use of Triumeq for HIV-infected patients and therefore clinicians prescribing this combination should be aware of this potential side effect and counsel their patients accordingly.